Individual provider Active NPI

Nyra Khetarpal, M.D.

  • Internal Medicine Physician
  • Apple Valley, CA
National Provider Identifier
1982999116
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A163181 Issued in CA
Practice address
18564 US Highway 18 Ste 103104
Apple Valley, CA 92307-2312
Phone
(760) 242-9262
NPI assigned
Jun 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X A163181 CA Primary

Addresses

Primary practice location

18564 US Highway 18 Ste 103104
Apple Valley, CA 92307-2312

Mailing address

19111 Town Center Dr
Apple Valley, CA 92308-8989
Phone (760) 242-7777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191115002274 CA Practitioner - Internal Medicine 2860617370 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Trident Medical Group IncGroup PAC ID 6608212899, 2 clinicians

Practice addresses (Care Compare)

18564 Outer Hwy 18
Suite 103
Apple Valley, CA 92307-2320
Phone (760) 242-9262

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A163181CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trident Medical Group Inc. Internal Medicine CurrentSince Nov 1, 2023 Accepting new patients
Choice Healthcare Associates, Inc. CurrentSince Sep 1, 2019 Accepting new patients
Uhs Corona Inc Past Accepting new patients

Locations

18564 US Highway 18
Ste 103104
Apple Valley, CA 92307
Phone (760) 242-9262

19111 Town Center Dr
Apple Valley, CA 92308
Phone (661) 345-3055

18522 US Highway 18
Ste 208
Apple Valley, CA 92307
Phone (760) 242-9262

18564 US Highway 18
Ste 103
Apple Valley, CA 92307
Phone (760) 242-9262

18564 US Highway 18
Ste 105
Apple Valley, CA 92307

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667779200000",
    "number": "1982999116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19111 TOWN CENTER DR",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923088989",
            "telephone_number": "760-242-7777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18564 US HIGHWAY 18 STE 103104",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072312",
            "telephone_number": "760-242-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHETARPAL",
        "first_name": "NYRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A163181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

Verify at the official NPI Registry.